Week 9 - Intervention Elements Of Change Flashcards
What are some pros and considerations to virtual treatment?
Pros:
- studies are showing it can be just as EFFECTIVE as in-person treatment
- STILL able to establish a therapeutic alliance
Considerations:
- requires a level of PRIVLEDGE
- technical difficulties
- have to establish DIFFERENT set of agreements
- have to confirm location
What should be considered in the treatment termination?
*Should be payed attention to
Ending of therapy CAN be mirror the ending of relationships
Can be clearer with strict time-limited therapies
&
More difficult for LONG-TERM treatment
LISTEN for & explore termination feelings
Important for BOTH client and therapist
What are some helpful techniques during termination?
What are some helpful techniques in termination?
Attribute PROGRESS to the client
REINFORCING SKILLS learned can be used in the FUTURE
Prepare client for SETBACKS – both during therapy and following termination
TAPER the FREQUENCY of sessions
DISCUSS thoughts and feelings related to termination
REVIEW skills and progress throughout therapy
*Self-help resources; relapse plans
*Booster sessions
What are 6 difficulties in intervention?
Abstract terms
Different techniques
Client variables
Therapist variables
Outcome variables
Process variables
What are 4 client variables?
- SES
• higher SES associated with engaging with and staying in treatment - Ethnicity
• matching associated with clients remaining in treatment
longer
• mixed research on outcome success - Gender
• women more likely to seek it out
• matching is unrelated - Age
• positively related to staying in treatment
• unrelated to treatment outcome
What are some positive treatment outcomes?
What are some poorer treatment outcomes?
(+):
- ego strength
- psychological mindedness
- low reactance
- (+) expectations
(-):
- more severe symptoms
- greater impairment in overall fxn
- presence of a personality disorder
What is psychological reactance?
Tendency to act AGAINST attempts to influence
- Low reactant:
- do best in DIRECTIVE TREATMENTS - High reactant:
- do best in LESS DIRECTIVE treatments
What are some therapist variables in intervention?
Ethnicity:
- limited research; some support for multicultural competence
Gender:
- no effect
Age:
- no effect
Professional background:
- mental health training is associated with more positive outcome than health training; inconclusive effects among different mental health professions
Experience:
- small positive effect
Well-being:
- positive effect
Judicious self-disclosure:
- small positive effect
What are some treatment variables in intervention?
Interpretation (psychodynamic; process-experiential):
- no consistent pattern across studies; positive effects with clients with good interpersonal skills
Directiveness (CBT):
- moderated by client reactance
Between session assignments (various):
- positive effect
Insight (various)
- most important for internalizing clients
Symptom reduction (various)
- most important for externalizing
***( ) = theoretical orientation
What are 3 common treatment factors?
- Support factors:
- reducing isolation
- providing reassurance
- therapist alliance
- therapist expertise
- therapist respect & empathy
- exploration of assumptions, beliefs & expectations - Learning factors:
- advice
- cognitive learning
- emotional experiencing
- insight
- feedback
- development of mastery
- behavioural regulation - Action factors:
- practice
- reality testing
- facing fears
- working through acceptance & warmth
- catharsis
- releasing tension
The therapeutic alliance contains what 3 aspects?
- Affective bonds
- Consensus about goals
- Sense of partnership
